REFRAMING STUDENT EXPERIENCES AND ATTITUDES TOWARDS WORKING WITH OLDER ADULTS

Abstract We are experiencing a shortage of trained health and social service providers to meet the needs of an aging society. However, few students have positive opportunities to work with older adults in their training. If they interact with older adults it is usually in end-of-life and nursing home care settings. We therefore need to find creative ways to motivate students in these fields to choose to work with older adults. We recruited students from health and social services programs to implement four health promotion projects at an older adult low-income residential community. We asked students (Nf22) to reflect on their experiences, and analyzed responses using a grounded theory approach. Myths regarding working with older adults included that they were mean, difficult, not technologically savvy, nor physically active. Initially nervous and uncertain about working with older adult prior to their experience, students gained confidence and had fun. They reported rewarding experiences, built relationships, and learned the benefits of prevention programs for older adults, and reconsidering their career trajectories to focus on working with older adults. Encouraging positive student experiences working with older adults can help prepare to develop the health and human services workforce for an aging society.

autonomy in activities of daily living (Bathing: 77.9%, dressing: 85.7%, toileting: 90.9%, indoor transfer: 89.6%; continence:75.3% and feeding: 94.8%). Only about half of the 2021/22 cohort were autonomous in these areas (40.0%, 44.3%, 54.7%, 42.5%, 63.2%, 46.7%, respectively). The number of chronic illnesses between the two cohorts were comparable (Mean(SD): 2011: 2.7 (1.6); 2021: 3.26 (1.60), yet dementia and frailty were more prevalent in the 2021 cohort (dementia: 44%; frailty: 9.1%) then the 2011 cohort (41.0%; 23.4%). Our findings alert metropolitans worldwide to the fast-increasing population of adults of advanced age with significant personal care and health needs in the community. Existing care for older adults has to be reframed and overhauled to provide comprehensive home-and personal-care support which will be essential for realizing ageing-in-place for adults in advanced age, especially after social distancing policies in COVID-19. Jieun Jang and Dae Kim, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts, United States Background: We assessed whether the frailty index measured at the beginning of elderhood can predict healthcare costs over 10 years in a nationwide Korean population. Methods: This retrospective cohort study included 215,887 individuals who underwent a standardized comprehensive geriatric assessment at the age of 66 years as part of the National Screening Program for Transitional Ages in 2007-2009 and participants were followed up until December 31, 2019, from the Korean National Health Insurance database. Frailty status was defined based on a 39-item frailty index: robust (< 0.15), pre-frail (0.15 to < 0.25), frail (≥0.25). Generalized linear model was used to examine any changes in healthcare cost among prefrail group, frail group following 10 years from the age of 66 years, relative to changes in healthcare cost of the robust group. This study constructed an interaction term between the frail group and age. Results: Frailty status at age 66 years was associated with an increased annual total healthcare cost per NHI beneficiary (robust * age vs frail * age: β = 89.5, SE = 4.0, P < .0001), annual inpatient healthcare cost per NHI beneficiary (robust * age vs frail * age: β = 70.3, SE = 4.1, P < .0001) over 10 years, but not significant in annual outpatient cost per NHI beneficiary after adjusting for frailty category, demographic factor, socioeconomic factor, and time fixed effect. Conclusions: The frailty index at the age of 66 years was associated with an accelerated increase in healthcare costs over 10 years.

A PSYCHOMETRICALLY ROBUST LONGITUDINAL RESEARCH MEASURE OF FRAILTY: FIVE DIMENSIONS ACROSS AGE AND TIME
Stacey Voll, 1 Graciela Muniz Terrera, 2 and Scott Hofer 1 , 1. University of Victoria,Victoria,British Columbia,Canada,2. Ohio University,Athens,Ohio,United States The research construct of frailty in aging requires a measure with sound psychometric properties, that is stable across longitudinal points of observation. Using Exploratory Factor Analysis and Longitudinal Mixed Methods, we developed a five-factor research measures of frailty that is robust across time. Standardized regression scores for each factor allow us to estimate the change in severity of dysfunction as individuals age. We propose a system for developing research tools for the concept of frailty in large longitudinal data sets, and present our findings of five factors of frailty for females and males from the English Longitudinal Study on Ageing. Prevalence of frailty among older sexual and gender minority adults (OSGM) is unknown despite disparities in mental health, medical comorbidities, and physical function. The NIH-funded All of Us Program was launched May 2018 aiming to enroll 1 million US participants focusing on those underrepresented in biomedical research, including OSGM. Using validated methods, we developed an All of Us deficit accumulation frailty index (AoU-FI) consisting of 33-items using baseline survey responses of adults aged 50+. Deficit domains include comorbidities, physical functioning, mental health, cognition, and sensory impairment. AoU-FI was valid if ≤20% of items were missing and ≤70% were comorbidities. OSGM self-identified or had discordance between gender and sex responses. OSGM (n=5,678) and non-OSGM (n=66,325), were similar in age (mean (IQR) = 66.7 (60-73) vs 66.9 (60-74)) but were more diverse (White 78% vs 82%, Black 7.5% vs. 6.5%, Hispanic/Latino 6.9% vs. 5.9%). AoU-FI had an expected gamma distribution across groups. OSGM frailty had a narrower range (0-0.67 vs. 0-0.75) and higher mean of 0.19 (sd=0.11) vs 0.17 (sd=0.1) compared to non-OSGM. To our knowledge, this is the first study of frailty among OSGM. Findings suggest OSGM experience worse frailty, highlighting the need to understand disparities in frailty, identify interventions, and develop policies to support OSGM. Additionally, our novel AoU-FI creates opportunities to apply frailty to diverse participants and types of data from digital health to genomics within the All of Us database.

REFRAMING STUDENT EXPERIENCES AND ATTITUDES TOWARDS WORKING WITH OLDER ADULTS Iveris Martinez, California State University, Long Beach, Long Beach, California, United States
We are experiencing a shortage of trained health and social service providers to meet the needs of an aging society. However, few students have positive opportunities to work with older adults in their training. If they interact with older adults it is usually in end-of-life and nursing home care settings. We therefore need to find creative ways to motivate students in these fields to choose to work with older adults. We recruited students from health and social services programs to implement four health promotion projects at an older adult low-income residential community. We asked students (Nf22) to reflect on their experiences, and analyzed responses using a grounded theory approach. Myths regarding working with older adults included that they were mean, difficult, not technologically savvy, nor physically active. Initially nervous and uncertain about working with older adult prior to their experience, students gained confidence and had fun. They reported rewarding experiences, built relationships, and learned the benefits of prevention programs for older adults, and reconsidering their career trajectories to focus on working with older adults. Encouraging positive student experiences working with older adults can help prepare to develop the health and human services workforce for an aging society.

YOU DON'T KNOW WHAT YOU DON'T KNOW: BLACK/LATINX CANCER SURVIVORS' KNOWLEDGE AND USE OF SURVIVORSHIP CARE PLAN Candidus Nwakasi, Cristy Romero, Kateri Sinkler, and Abigail Pawlowicz, Providence College, Providence, Rhode Island, United States
Compared to Whites, Black and Latinx cancer survivors and their families experience disproportionate adverse effects of cancer and cancer therapy. This is due to extreme psychosocial, physical, emotional, and financial challenges they experience, thus, highlighting racial/ethnic disparity in cancer survivorship. A cancer survivorship care plan (SCP) is important for improving cancer health and quality of life, but the effectiveness of SCP as a tool to address the disproportionately persistent poor health and quality of life of Blacks/Latinx compared to Whites deserve critical attention. This study is part of a larger study on evaluating cancer survivorship in Rhode Island. We explored knowledge and use of SCP among Blacks and Latinx cancer survivors in Rhode Island. The study employed a qualitative descriptive method. Semi-structured interviews in English and Spanish were conducted with a purposive sample of 12 cancer survivors, 8 Latinx and 3 Blacks (Mage = 62 years). Their responses were transcribed and analyzed for themes. The 3 major themes identified were: 1) invisibility of survivors; 2) understanding the needs of cancer survivors; and 3) issues of empowerment. Our findings draw attention to the need for tailored interventions targeting Black/Latinx cancer survivors. One of such interventions include designing programs to increase the accessibility of SCP to help improve quality of life of cancer survivors from disadvantaged population groups.

THE IMPACT OF A DIGITAL CANCER SURVIVORSHIP PATIENT ENGAGEMENT TOOLKIT ON OLDER CANCER SURVIVORS' HEALTH OUTCOMES
Eun-Shim Nahm, 1 Mary McQuaige, 2 Katarina Steacy, 2 Nancy Corbit, 2 Shijun Zhu, 1 and Hohyun Seong 1 , 1. University of Maryland School of Nursing, Baltimore,Maryland,United States,2. University of Maryland Marlene and Stewart Greenbaum Comprehensive Cancer Center,Baltimore,Maryland,United States Cancer is a disease that predominantly affects older adults. The median age at diagnosis is 66 years and 62% of the 15.5 million American cancer survivors are age ≥65 years. Provision of supportive care after treatment is critical to this group due to their complex care needs; however, limited resources are available to them. As increasing numbers of older survivors adopt technology, digital health programs have significant potential to help them improve their health and communicate with their providers. Previously, we developed/ tested a digital Cancer Survivorship Patient Engagement Toolkit program for older adults, CaS-PET Silver. The aim was to examine the preliminary impact of CaS-PET Silver on older survivors' health outcomes. This was a 2-armed RCT with two observations (baseline, 8 weeks) on a sample of 60 survivors age ≥65 years (mean age, 70.1±3.8), who were treated with curative intent within 12 months from enrollment (02/2020-01/2022, COVID-19 pandemic). Outcomes included health-related quality of life (HRQoL), self-efficacy for coping with cancer, symptom burden, health behaviors, and patient-provider communication. Data were analyzed using descriptive statistics, linear mixed models, and content analysis. The majority of participants were black (68.3%, n=41) and female (56.6%, n=34). At 8 weeks, CaS-PET Silver group showed significantly improved physical HRQoL (p < .001, ES=0.64) and symptom burden (p=.053, ES= -0.41). Self-efficacy (ES=0.56), mental HRQoL (ES=0.26), and communication (ES=0.40) showed a tendency to improve. Most participants reported benefits from the program on health management (mean, 19.41±2.6 [3-21] The National Diabetes Prevention Program established by the Centers for Disease Control and Prevention promotes the implementation of an evidence-based lifestyle change program (LCP) to prevent or delay the onset of diabetes. The LCP is a 12-month program with 26 lessons covering topics on healthy diets, increasing physical activity, managing stress, and coping with triggers, among others. It includes weekly goal setting, food, and physical activity tracking, and group support. The goals of the program are 5-7% sustained weight loss and 150 minutes of physical activity weekly. Little is known about the real-world effectiveness of the LCP in different age groups, particularly in older adults. The aim of this study was to evaluate the effects of age on LCP outcomes (weight loss, average physical activity, program attendance) conducted by Virginia Cooperative Extension from 2017 -2022. Among 191 participants enrolled in the